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General NPI Number Information
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NPI Number | 1366075723
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Entity Type | Organization
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Legal Business Name | CAPACITY COUNSELING, PLLC
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Dates
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Enumeration Date | 02/13/2020
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Last Update Date | 02/13/2020
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Provider Practice Location Address
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Address Line | 42705 GRAND RIVER AVE STE 201
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City | NOVI
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State | MI
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Zip | 48375-1772
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Country | US
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Telephone | 248-417-0229
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Fax |
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Provider Business Mailing Address
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Address Line | 42705 GRAND RIVER AVE STE 201
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City | NOVI
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State | MI
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Zip | 48375-1772
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Country | US
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Telephone | 248-329-3099
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Fax |
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Authorized Official
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Title or Position | CLINICAL THERAPIST
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Name | LISA HAMBURG
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Credential | LMSW
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Telephone | 248-329-3099
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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